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Guide to Diabetes

 Diabetic Foot problems 

High Risk foot

If your diabetes is not controlled properly it can lead to complications with your feet, this happens when blood circulation and nerves to the feet are damaged. Your feet need to be checked at least annually to assess for any problems which you may not be aware of.

 

Common Foot Problems 


  • Blisters 
  • Corns 
  • Calluses 
  • Fungal Infections. (Usually thick, crumbly and white, grey or yellow nails are a sign of fungal Infection.)
     

Download our Footwear Advice.

Each year your feet should be assesed by a trained healthcare professional to identify the possible risk of foot complications
 

LOW RISK 
 

  • Normal Sensation
  • Normal circulation 
  • No foot deformity
  • Risk the same as the general population
     


MODERATE RISK - You have one risk factor i.e.

Moderate risk

1. Poor Blood Circulation
 

You may experience cramp like pains in the calfs and feet.


Smoking increases further damage to your circulation; therefore it is in your best interest to stop. As it reduces the oxygen levels in your blood.
 

Tip: When resting do not cross your legs as this can restrict your circulation.


2. The Ischaemic (lack of blood supply) Foot 
 

The ischaemic foot is cold and without a pulse, causes pain when resting, and is prone to ulceration and gangrene. Ischaemic ulceration usually affects the sides of the foot. 
 

 

3. Poor Sensation (Neuropathy)
 

Diabetes can affect the nerves in your feet causing loss of feelings and sensation, awareness of temperature change, touch and pain. As a result foot problems may occur without you being aware of them. Such damage may lead to infection.

You may experience some of the following symptoms:

  • Loss of pain sensation
  • Tingling
  • Pins and Needles
  • Shooting pain burning sensations
  • Detailed explanation of Neuropathatic Pain

 

It is essential in all cases that you examine your feet everyday for changes, cuts and abrasions as walking on an injured foot could cause further damage. If you suffer a foot injury, however minor this is potentially serious and you MUST seek medical help, contact your podiatrist or GP.


4. Altering the shape of your feet 

Diabetes can cause damage to the nerves in your feet which can alter the shape of your feet. You may develop a high arch, which will cause the ball of your foot to become prominent and the toes to claw. If you have difficulty finding shoes to fit, you may need specially made shoes. See your doctor or podiatrist as these are only made on prescription.

 


Diabetes Related Problems- HIGH RISK 


high risk foot

5. The Neuropathic Foot (damage of nerves and loss of sensation) 

The neuropathic foot is numb, warm and dry, with pulses; complications include neuropathic ulcer, Charcot arthropathy and (rarely) neuropathic swelling (oedema). Neuropathic ulcers occur at points of high pressure loading, especially on the soles or at the sites where the foot has changed shape. Pressure damage causes hard bumpy skin areas (callosity), the self destruction of tissue (autolysis) and finally ulceration. Secondary infection is common. 
Download our High Risk footcare advice 
 

6. Foot Ulceration  

One of the complications of diabetes is ulceration of the foot (cuts and abrasions/ scraped areas) on the skin, which does not heal and is accompanied by inflammation. This can be because of the conditions mentioned neuropathy and ischaemia (lack of blood supply), frequently acting in combination and often complicated by infection, leading to ulceration of the diabetic foot. Bruising under callous can indicate that tissue breakdown or ulceration can be underneath the hard skin. 

 

Foot ulcers are the most common complication leading to hospitalisation in diabetes. If it’s not checked it can lead to greater problems with your legs. In the worst case amputation may be required. Risk factors Include:

  • Hyperglycaemia

  • Smoking

  • High blood pressure (Hypertension)

  • Neuropathy (damage to nerves and loss of sensation)

  • Circulation problems

  • Callus (hard skin)

Foot ulcers are a common problem in people with diabetes. Risk is reduced with careful daily foot care. download our Looking after your  Diabetes footulcer Advice 
 

7. Charcot Arthropathy

This is a damaged, swollen and deformed joint in the foot (Charcot’s joint) caused by repeated a minor injury which you can be unaware of because the nerves that normally register pain are damaged. The foot is swollen, warm and red which is sometimes painful. Bone scans allow early diagnosis and radiographs later show disorganisation of the joint and new bone formation. The treatment is by immobilising (not moving) the limb with non- steroidal anti- inflammatory drugs for pain. (See Antimicrobial Guidelines for the diabetic foot infections
 

The Diabetes Foot Clinic specialises in the treatment of diabetes related foot problems and in particular foot ulcers


Documents

Diabetes Footcare - High Risk booklet

Information about footcare for patient at high risk of diabetes foot problems Download Document

Diabetes Footcare - Low Risk

Information about Diabetes footcare for people with Low risk of foot problems Download Document

Diabetes Footcare - Looking after your foot ulcer booklet

Information about looking after your diabetes foot ulcer Download Document

Diabetes Footcare Advice Booklet - Footwear

Information about the wearing the correct footwear Download Document

Diabetes Footcare - Moderate Risk

Information about foot care for people at Moderate risk of foot problems Download Document